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Review
. 2025 Jun 9;7(1):tzaf016.
doi: 10.1093/bjro/tzaf016. eCollection 2025 Jan.

Being a radiation oncologist: times of crisis for European graduates

Federico Gagliardi  1 , Emma D'Ippolito  1 , Roberta Grassi  1 , Angelo Sangiovanni  1 , Vittorio Salvatore Menditti  1 , Dino Rubini  1 , Paolo Gallo  1 , Luca D'Ambrosio  1 , Massimo Minerva  2 , Viola Salvestrini  3 , Francesca De Felice  4 , Giuseppe Carlo Iorio  5 , Antonio Piras  6 , Luca Nicosia  7 , Gian Marco Petrianni  8 , Luca Boldrini  9 , Valerio Nardone  1
Affiliations
Review

Being a radiation oncologist: times of crisis for European graduates

Federico Gagliardi et al. BJR Open. .

Abstract

This study examines the shortage of radiation oncologists in Italy and Europe, analysing systemic challenges in postgraduate training and proposing solutions to enhance the appeal of radiation oncology. A review of literature from Italy and Europe evaluated trends in training programmes, workforce dynamics. Analysis included residency vacancies, economic constraints, training disparities, and visibility of the field during medical education. In Italy, 55.3% of radiation oncology residency positions have gone unfilled or been abandoned since 2016, with 90% of positions vacant in 2023. Contributing factors include inadequate exposure to radiotherapy during medical training, limited financial opportunities, negative societal perceptions, and high levels of burnout. Across Europe, similar challenges persist. Training disparities, outdated infrastructure, and regional inequalities exacerbate workforce shortages, particularly in low-income countries. Addressing the radiation oncology crisis requires a multifaceted strategy, including enhancing visibility of the field in medical education, improving working conditions, offering financial incentives, and addressing disparities in training quality across Europe. The European radiotherapist shortage is a systemic issue requiring coordinated efforts to standardize training, address economic barriers, and improve the specialty's appeal. By fostering collaboration and reform, European nations can meet the growing demand for cancer care and secure a sustainable workforce for the future.

Keywords: European oncology; European radiotherapy; Healthcare policy; Italian radiotherapy; radiotherapy; residency training.

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Conflict of interest statement

None declared.

Figures

Figure 1.
Figure 1.
Available annual medical residency positions.
Figure 2.
Figure 2.
Number of total participants and available medical residency positions in Italy from 2016 to 2024, along with their ratio.
Figure 3.
Figure 3.
Summary of residency positions in radiation oncology from 2016 to 2024, showing the percentage of assigned and unassigned positions over the years.
See this image and copyright information in PMC

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